Lessons learned from a pneumocystis pneumonia outbreak at a Scottish renal transplant centre.
Adult
Aged
Aged, 80 and over
Case-Control Studies
Cross Infection
/ epidemiology
Disease Outbreaks
Disease Transmission, Infectious
Female
Humans
Immunocompromised Host
Kidney Transplantation
Male
Middle Aged
Opportunistic Infections
/ epidemiology
Pneumocystis carinii
/ isolation & purification
Pneumonia, Pneumocystis
/ epidemiology
Retrospective Studies
Risk Factors
Scotland
/ epidemiology
Transplant Recipients
Outbreak
Pneumocystis jirovecii
Pneumonia
Renal transplant
Journal
The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
received:
02
11
2018
accepted:
18
02
2019
pubmed:
26
2
2019
medline:
30
11
2019
entrez:
26
2
2019
Statut:
ppublish
Résumé
Pneumocystis pneumonia (PCP) is an opportunistic infection occurring in renal transplant patients. Over a 14-month period an increase in PCP cases was identified among our renal transplant cohort. The outbreak population was studied to identify potential risk factors for the development of PCP. A retrospective analysis of hospital records was carried out, with each case being matched with two case-linked controls. Information was collected on patient demographics, laboratory tests, and hospital visits pre and post development of infection. No patients were receiving PCP prophylaxis at the time of infection and mean time from transplantation to developing PCP was 4.7 years (range: 0.51-14.5). The PCP group had a significantly lower mean estimated glomerular filtration rate than the control group (29.3 mL/min/1.73 m This study highlights the ongoing risk of opportunistic infection several years after transplantation and adds weight to potential person-to-person Pneumocystis jirovecii transmission. Risk factors have been identified which may highlight those most at risk, enabling targeted rather than blanket long-term PCP prophylaxis.
Sections du résumé
BACKGROUND
BACKGROUND
Pneumocystis pneumonia (PCP) is an opportunistic infection occurring in renal transplant patients. Over a 14-month period an increase in PCP cases was identified among our renal transplant cohort.
AIM
OBJECTIVE
The outbreak population was studied to identify potential risk factors for the development of PCP.
METHODS
METHODS
A retrospective analysis of hospital records was carried out, with each case being matched with two case-linked controls. Information was collected on patient demographics, laboratory tests, and hospital visits pre and post development of infection.
FINDINGS
RESULTS
No patients were receiving PCP prophylaxis at the time of infection and mean time from transplantation to developing PCP was 4.7 years (range: 0.51-14.5). The PCP group had a significantly lower mean estimated glomerular filtration rate than the control group (29.3 mL/min/1.73 m
CONCLUSION
CONCLUSIONS
This study highlights the ongoing risk of opportunistic infection several years after transplantation and adds weight to potential person-to-person Pneumocystis jirovecii transmission. Risk factors have been identified which may highlight those most at risk, enabling targeted rather than blanket long-term PCP prophylaxis.
Identifiants
pubmed: 30802526
pii: S0195-6701(19)30096-9
doi: 10.1016/j.jhin.2019.02.013
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
311-316Informations de copyright
Copyright © 2019 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.